Post Traumatic Epilepsy (PTE)

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Post-Traumatic Epilepsy (PTE) refers to a recurring seizure disorder, the reason for which is believed to be a trauma or injury to the brain. This injury can be a result of head trauma or a sequel to an operation on the brain.

The term PTE must be differentiated from the term posttraumatic seizure (PTS), which signifies any seizure that occurs as a sequel to brain injury. If the seizures occur within 24 hours of the injury, they are called immediate PTSs. A PTS that occurs within 1 week of injury is termed early PTS, and a seizure that occurs more than 1 week after injury is termed late PTS.

Symptoms of Post-Traumatic Epilepsy

A “seizure” is a change in consciousness or behavior that is a result of an electrical disturbance in the brain. Seizures can be very obvious and dramatic, such as when someone suddenly stiffens up, loses consciousness and falls to the floor and shakes. Seizures can also be less obvious, such as when a person has a lapse in memory, or stares into space for a few seconds, or does something odd, but doesn’t remember doing it.

Although the incidence of epilepsy in the general population is estimated at 0.5-2%, the incidence of PTS for all types of head injuries is 2-2.5% in civilian populations.

Causes of Post-Traumatic Epilepsy

1. Severity of trauma
2. Penetrating head injuries
3. Intracranial hematoma
4. Depressed skull fracture
5. Hemorrhagic contusion
6. Coma lasting more than 24 hours
7. Early PTS

Treatment of Post-Traumatic Epilepsy

Antiepileptic drugs may be given to prevent further seizures; these drugs completely eliminate seizures for about 35% of people with PTE. However, antiepileptics only prevent seizures while they are being taken; they do not reduce the occurrence once the patient stops taking the drugs. Medication may be stopped after seizures have been controlled for two years.

People whose PTE does not respond to medication may undergo surgery to remove the epileptogenic focus, the part of the brain that is causing the seizures

People with PTE have follow-up visits, in which health care providers monitor neurological and neuropsychological function and assess the efficacy and side effects of medications.